Bone destruction in rheumatoid arthritis: role of autoantibodies

Abstract

Objective: to assess an association between the levels of anti-cyclic citrullinated peptide antibodies (anti-CCP), anti-modified citrullinated vimentin antibodies (anti-MCV), rheumatoid factor (RF), and X-ray signs of destructive changes in RAjoints. Subjects and methods. One hundred and fourteen patients with RA were examined. All the patients received therapy with disease-modifying antirheumatic drugs and 61.4% took glucocorticoids. The investigators determined erythrocyte sedimentation rate (ESR) by the Westergren method, serum anti-MCV concentrations (U/ml) by enzyme immunoassay (EIA), anti-CCP levels by electrochemiluminescence and EIA. The modified Sharp method was used to quantify X-ray changes. Results. The total Sharp score (TSS; Me [the 25th and 75th percentile]) was 89 [57; 117]; the number of erosions and stenoses was 9 [3; 27] and 76 [51; 99], respectively; anti-MCV levels were 470.2 [106.9; 1000] U/ml. According to the level of RF IgM-, anti-CCP-, and anti-MCV-positivity, all the patients were divided into groups. High anti-MCV positive patients (n = 80) were observed to have higher TSS (96.5 [66.0; 120.0]), a larger number of stenosis (82.0 [60.5; 105.5]), and greater inflammatory disease activity (ESR, 40 [30; 61]) than negative/low positive patients (n = 25) who had 57 [31; 88], 50 [29; 82], 30 [21; 48.5] respectively; p < 0.05). No significant differences in joint destruction were found in the patient groups according to RF IgMand anti-CCP-positivity. Conclusion. Anti-MCV shows a greater degree of bone destruction and is associated with higher inflammatory disease activity than anti-CCP.

Keywords

• rheumatoid arthritis
• joint destruction
• igm rheumatoid factor
• anti-cyclic citrullinated peptide antibodies
• anti-modified citrullinated vimentin antibodies
• inflammatory markers